Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether the specialised services circular issued by NHS England on 30 September 2013, ID SSC1315, on Individual Funding Requests for Clinically Urgent Treatment Outside Established Policy, remains in force; whether individual requests for treatments for which a cohort policy is in development will not be funded without evidence of clinical exceptionality; how many individual funding requests for (a) all treatment and (b) Duodopa were (i) approved and (ii) not approved under the (A) critical clinically urgent criteria and (B) urgent non-clinical criteria in each month in which that circular has been in force; if all requests made under the urgent non-clinical criteria received expert opinion from the Chair of the relevant clinical reference group within two weeks; and if he will make a statement.
NHS England has confirmed that, to be successful, any individual funding request (IFR) for Duodopa must demonstrate exceptionality against the cohort of patients with Parkinson's disease in NHS England’s draft commissioning policy.
Although it does not routinely commission Duodopa for the treatment of advanced Parkinson’s disease, NHS England has advised that, it will consider funding this treatment in exceptional clinical circumstances. Clinicians can submit IFRs for this treatment to NHS England on behalf of their patients.
NHS England has IFRs for all treatments/interventions were received by NHS England through the standard IFR process. 238 of these were considered by an NHS England IFR panel.
21 requests for Duodopa were received as shown in the table.
IFR team | Indication | Number of IFRs received | Approved | Not Approved |
Midlands and East | Duodopa | 3 | 0 | 3 |
North | Duodopa | 5 | 0 | 5 |
London | Duodopa | 11 | 0 | 11 |
South | Duodopa | 2 | 0 | 2 |
Source: NHS England
NHS England is unable to provide monthly figures due to the small volume of requests as this could lead to the identification of individual patients.
NHS England has advised that the SSC1315 on Individual Funding Requests for Clinically Urgent Treatment Outside Established Policy has officially expired but has been maintained whilst a review is taking place regarding how such cases will be handled in the future.
It has confirmed that not all non-clinical IFRs require an expert opinion. This is only sought when it is felt that further expert opinion is required. It should be noted that Duodopa became NHS England’s responsibility from April 2014. Prior to then cases were considered by clinical commissioning groups.
Details of IFRs processed under specialised services circular SSC1315 for the period 1 October 2013 to 24 February 2015 are shown in the table:
IFR team | Indication | Number of IFRs received | Approved | Not Approved | ||
critical clinically urgent | urgent non-clinical | critical clinically urgent | urgent non-clinical | |||
Midlands & East | All | 11 | 5 | 6 | 0 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
North | All | 13 | 12 | 0 | 1 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
London | All | 37 | 31 | 3 | 3 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
South | All | 18 | 10 | 1 | 3 | 4 |
Duodopa | 6 | 0 | 0 | 0 | 0 |
Source: NHS England
Further information about NHS England’s IFR process is available at:
www.england.nhs.uk/wp-content/uploads/2013/04/cp-03.pdf